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https://www.readbyqxmd.com/read/28435930/spinal-subdural-hematoma-a-rare-case-of-spinal-subdural-hematoma-complicating-routine-minimally-invasive-lumbar-discectomy-and-decompression-and-relevant-literature-review
#1
Chelsea C Boe, Brett A Freedman, Ravi Kumar, Kendall Lee, Robert McDonald, John Port
We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic injury. Hitherto, no case of acute postoperative subdural hematoma has been reported in the postoperative setting in the absence of known iatrogenic dural injury. A 76-year-old male with central and lateral recess spinal stenosis underwent apparently uncomplicated bilateral L3-4 and left sided L4-5 decompressive partial laminectomies and discectomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435915/impact-of-surgical-approach-on-complication-rates-after-elective-spinal-fusion-%C3%A2-3-levels-for-adult-spine-deformity
#2
Aladine A Elsamadicy, Owoicho Adogwa, Shay Behrens, Amanda Sergesketter, Angel Chen, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: While there are variations in techniques and surgical approaches to spinal fusion, there is not a defined consensus on a recommended surgical approach. The aim of this study is to determine if there was a difference in intra- and post-operative complication rates between different surgical approaches after elective spinal fusion (≥3 levels) for adult spine deformity. METHODS: The medical records of 443 adult spine deformity patients undergoing elective spinal fusion (≥3) at a major academic institution from 2005 to 2015 were reviewed...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28412565/the-use-of-a-novel-perfusion-based-cadaveric-simulation-model-with-cerebrospinal-fluid-reconstitution-comparing-dural-repair-techniques-a-pilot-study
#3
Joshua Bakhsheshian, Ben A Strickland, Neil N Patel, Andre M Jakoi, Michael Minneti, Gabriel Zada, Frank L Acosta, Patrick C Hsieh, Jeffrey C Wang, John C Liu, Martin H Pham
BACKGROUND CONTEXT: Watertight dural repair is crucial for both incidental durotomy and closure after intradural surgery. PURPOSE: To describe a perfusion-based cadaveric simulation model with cerebrospinal-fluid (CSF) reconstitution and to compare spine dural repair techniques. STUDY DESIGN/SETTING: Fresh Tissue Dissection Laboratory. SAMPLE SIZE: 8 fresh human cadavers. OUTCOME MEASURES: A watertight closure was achieved when pressurized saline up to 40 mm Hg did not cause further CSF leakage beyond the suture lines...
April 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28400658/complication-rate-during-multilevel-lumbar-fusion-in-patients-above-60-years
#4
Bijjawara Mahesh, Bidre Upendra, S Vijay, Gc Arun Kumar, Srinivas Reddy
BACKGROUND: Spine surgery in elderly with comorbidities is reported to have higher complication rates and increased cost. However, the surgical outcome is good irrespective of the complications. Hence, it is essential to identify the factors affecting the complication rates in such patients and the measures to reduce them. This retrospective observational study determines the perioperative complications, their incidence and the measures to reduce complications in the elderly with comorbidities, operated by instrumented multilevel lumbar fusion...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28377861/outpatient-anterior-cervical-discectomy-and-fusion-an-analysis-of-readmissions-from-the-new-jersey-state-ambulatory-services-database
#5
Shearwood McClelland, Peter G Passias, Thomas J Errico, R Shay Bess, Themistocles S Protopsaltis
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) performed as an outpatient has become increasingly common for treating cervical spine pathology. Few reports have attempted to assess readmissions following outpatient ACDF. This study was performed to address this issue using population-based databases. METHODS: The State Ambulatory Services Database (SASD) for New Jersey (NJ) from 2003-2012 was used for analysis. Patients receiving ACDF (defined as anterior cervical fusion (ICD-0 code=81...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28368483/national-rates-causes-risk-factors-and-outcomes-associated-with-30-day-and-90-day-readmissions-following-degenerative-posterior-cervical-spine-surgery-utilizing-the-nationwide-readmissions-database
#6
Kavelin Rumalla, Kyle A Smith, Paul M Arnold
BACKGROUND: Hospital readmissions have profound financial and clinical impacts. Analyses of 30-day readmissions following spine surgery have been previously reported utilizing administrative databases. However, time periods outside the initial 30 days have not been well studied. Furthermore, these databases have limitations regarding coding and institutional crossover. OBJECTIVE: The authors sought to analyze 30-day and 90-day readmission rates and risk factors using the Nationwide Readmissions Database (NRD) in a retrospective cohort receiving elective, posterior cervical spine surgery for degenerative conditions...
March 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28359921/increased-30-day-complication-rates-associated-with-laminectomy-in-874-adult-spine-deformity-patients-undergoing-elective-spinal-fusion-a-single-institutional-study
#7
Aladine A Elsamadicy, Owoicho Adogwa, Hunter Warwick, Amanda Sergesketter, Emily Lydon, Ronnie L Shammas, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Recent studies have reported that decompression with fusion leads to superior outcomes in the correction of spinal deformity. The aim of this study is to determine if there is a difference in intraoperative and 30-day postoperative complication rates in patients undergoing spinal fusion with and without decompression. METHODS: The medical records of 874 adult (≥18 years old) spine deformity patients undergoing elective spinal fusion at a major academic institution from 2005 to 2015 were reviewed...
March 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28331980/combined-intra-extradural-approach-for-posterolateral-thoracic-disk-herniations-preliminary-study-and-technical-note
#8
Antonio Bocchetti, Valentina Cioffi, Raffaele de Falco
Purpose Thoracic disk herniation is uncommon. It still represents a challenge for spinal surgeons. Multiple surgical strategies are available and, often, they are matter of debate. We describe a preliminary experience about a combined extra-intra dural approach for posterolateral disk herniation in patients affected by spinal cord compression. METHODS: We performed a combined extra-intra dural approach in two preliminary cases. We performed bilateral laminectomy of adjacent vertebrae and unilateral partial medial arthrectomy of the involved segment...
March 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28304232/a-systematic-evaluation-of-intraoperative-white-matter-tract-shift-in-pediatric-epilepsy-surgery-using-high-field-mri-and-probabilistic-high-angular-resolution-diffusion-imaging-tractography
#9
Joseph Yuan-Mou Yang, Richard Beare, Marc L Seal, A Simon Harvey, Vicki A Anderson, Wirginia J Maixner
OBJECTIVE Characterization of intraoperative white matter tract (WMT) shift has the potential to compensate for neuronavigation inaccuracies using preoperative brain imaging. This study aimed to quantify and characterize intraoperative WMT shift from the global hemispheric to the regional tract-based scale and to investigate the impact of intraoperative factors (IOFs). METHODS High angular resolution diffusion imaging (HARDI) diffusion-weighted data were acquired over 5 consecutive perioperative time points (MR1 to MR5) in 16 epilepsy patients (8 male; mean age 9...
March 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28223250/dorsal-cervical-spinal-cord-herniation-precipitated-by-kyphosis-deformity-correction-for-spinal-cord-tethering
#10
Robert S Heller, Steven W Hwang, Ron I Riesenburger
INTRODUCTION: Cervical spinal cord herniation is a rare clinical entity. Reported after previous intradural surgery or surgery complicated by durotomy, patients return several months to years later with symptoms of worsening myelopathy. Herein is presented a case of a 51-year-old female patient with spinal cord herniation in the cervical spine after kyphosis deformity correction. CASE DESCRIPTION: A 51-year old female patient presented to the neurosurgery clinic with worsening cervical myelopathy due to cervical spinal cord tethering and adhesions from previous intradural surgery for Chiari malformation...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28192271/ventral-spontaneous-durotomy-following-vaginal-delivery
#11
Nitin Agarwal, Ahmed I Kashkoush, Arpan V Prabhu, Raymond F Sekula
INTRODUCTION: Dural breaches have a diverse etiology, including spontaneous rupture and trauma. Most cases resolve with bedrest, though in refractory cases an epidural blood patch can be placed to obstruct further leakage. Here, we discuss a unique case of a spontaneous ventral durotomy following vaginal delivery managed with injections of autologous blood through bilateral transforaminal needles. CLINICAL PRESENTATION: A previously healthy 36-year-old pregnant female presented to the inpatient maternity ward with positional occipital headaches and neck pain 24 hours following normal spontaneous vaginal delivery...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28192259/impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#12
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Gireesh Reddy, Rayan Kaakati, Amanda Sergesketter, Oren N Gottfried, Isaac O Karikari
OBJECTIVE: The aim of this study is to determine if there are differences in 30-day postoperative complication and readmission rates between spinal deformity patients undergoing complex spinal fusion with and without intraoperative monitoring. METHODS: The medical records of 643 adult spine deformity patients undergoing elective complex spinal fusion (≥4 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 122 (19%) cases that involved intraoperative monitoring (IOM) including EMG, SSEP, and/or TcMEP and 521 (81%) that did not (IOM: n=122; No-IOM: n=521)...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185018/efficacy-and-safety-of-durotomy-after-decompressive-hemicraniectomy-in-traumatic-brain-injury
#13
R B Moringlane, N Keric, F B Freimann, D Mielke, R Burger, D Duncker, V Rohde, K L V Eckardstein
Decompressive hemicraniectomy (DH) plus duroplasty was demonstrated to be effective for treating critically elevated intracranial pressure (ICP). In order to shorten operation time and to avoid the use of autologous or heterologous material, durotomy has been introduced as an alternative to duroplasty. Only limited data is available on the effect of DH and durotomy on the increased ICP in traumatic brain injury (TBI). Therefore, we collected consecutive intraoperative ICP readings during the different steps of DH and durotomy in TBI patients...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#14
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28024891/transdural-herniated-lumbar-disc-disease-with-muscle-patch-for-closure-of-durotomy-a-brief-review-of-literature
#15
REVIEW
Harsha A Huliyappa, Rakesh Kumar Singh, Sunil Kumar Singh, Manish Jaiswal, Somil Jaiswal, Chhitij Srivastava, Balkrishna Ojha, Anil Chandra, Satnam Chhabra
PURPOSE: Intradural migration of disc (IDMD) is a rare clinical entity accounting for 0.27-0.33% of all herniated disc diseases. Flimsy or dense adhesion between the ventral dural surface and the opposing posterior longitudinal ligament (PLL) is the principal pathology for intradural migrated disc. The most commonly affected lumbar segments are L4-5 (55%), L3-4 (16%), L5-S1 (10%) and less commonly L2L3 and L1L2. No imaging feature is characteristic and the management protocol of durotomy via an endoscopic method is unclear...
December 15, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27942941/migratory-low-velocity-intradural-lumbosacral-spinal-bullet-causing-cauda-equina-syndrome-report-of-a-case-and-review-of-literature
#16
Sachin Baldawa, Vijay Shivpuje
BACKGROUND: Migration of the bullet within the spinal subarachnoid space has long been recognized as unusual complication of spinal gunshot injury. OBJECTIVE: We report a case of migratory low velocity intradural lumbosacral spinal bullet causing cauda equina syndrome. The relevant literature is reviewed and all cases of migratory spinal bullet are summarised, and management strategies are discussed. STUDY DESIGN: Literature review. METHODS: A 32-year-old male suffered abdominal gunshot injury for which emergency laparotomy and repair of colonic perforation were performed...
December 9, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27922581/pseudomeningocele-aspiration-and-blood-patch-effectively-treats-positional-headache-associated-with-post-operative-lumbosacral-pseudomeningocele
#17
Stephen Sandwell, Kevin Walter, Per-Lennart Westesson
STUDY DESIGN: Retrospective chart review with limited prospective follow-up survey. OBJECTIVE: To evaluate the efficacy and safety of blood patch injection for the treatment of positional headaches caused by postoperative lumbosacral pseudomeningoceles. SUMMARY OF BACKGROUND DATA: Pseudomeningocele is one of the most common complications after posterior lumbosacral spinal surgery. Common treatments include bedrest, abdominal binder use, subarachnoid lumbar drainage, and surgical re-exploration for durotomy closure...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27853662/postoperative-cerebrospinal-fluid-leak-rates-with-subfascial-epidural-drain-placement-after-intentional-durotomy-in-spine-surgery
#18
Tianyi Niu, Derek S Lu, Andrew Yew, Darryl Lau, Haydn Hoffman, David McArthur, Dean Chou, Daniel C Lu
Study Design Retrospective chart review. Objective Postoperative cerebrospinal fluid (CSF) leak is a known complication of intraoperative durotomy. Intraoperative placement of subfascial epidural drains following primary dural repair has been proposed as a potential management strategy to prevent formation of CSF cutaneous fistula and symptomatic pseudomeningocele. Here we describe our experience with subfascial drain after intentional durotomy. Methods Medical records of patients who underwent placement of subfascial epidural drains during spinal procedures with intentional intraoperative durotomies over a 4-year period at two institutions were retrospectively reviewed...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27815027/teratoma-of-the-spinal-cord-in-an-adult-report-of-a-rare-case-and-review-of-the-literature
#19
REVIEW
Richard F Schmidt, James P Casey, Ashish R Gandhe, Mark T Curtis, Joshua E Heller
Teratomas of the spinal cord are incredibly rare, comprising less than 0.5% of all spinal cord tumors. These tumors are exceptionally rare in adults, with only a handful of cases reported in the literature. We present the case of a 49-year-old gentleman with new onset urinary incontinence who presented with a large intradural tumor of the thoracolumbar spine. The patient underwent a laminectomy with midline durotomy for subtotal tumor resection. Surgical pathology diagnosed the tumor as a mature teratoma, exhibiting the presence of all three germ layers...
February 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27765561/impact-of-parkinson-s-disease-on-perioperative-complications-and-hospital-cost-in-multilevel-spine-fusion-a-population-based-analysis
#20
Shearwood McClelland, Joseph F Baker, Justin S Smith, Breton G Line, Thomas J Errico, Christopher P Ames, R Shay Bess
Parkinson's disease (PD) is a neurodegenerative disorder manifesting over time to result in reduced mobility. The impact of PD on spinal fusion has yet to be addressed on a nationwide level. The Nationwide Inpatient Sample (NIS) from 2001 to 2012 was used for analysis. Admissions with spinal fusion of two or more vertebrae (ICD-9 codes=81.62, 81.63 and 81.64) were included and then stratified based on the presence or absence of PD (ICD-9 code=332.0); patients with cancer (ICD-9 codes=140-239) or trauma (ICD-9 codes=805...
January 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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